经皮与开放椎弓根螺钉内固定治疗脊柱骨折患者效果比较

Percutaneous versus open internal fixationwith pedicle screw in treatment of patients with spinal fractures

  • 摘要:
      目的  比较经皮与开放椎弓根螺钉内固定治疗脊柱骨折患者的疗效。
      方法  将60例脊柱骨折患者分为经皮组与开放组,每组30例。比较2组患者围术期指标、疼痛视觉模拟评分(VAS)、疼痛数字评分(NRS)、脊柱椎体指标、术后并发症。
      结果  经皮组术中出血量少于开放组,术后卧床时间、住院时间低于开放组,差异有统计学意义(P < 0.05);术后2周,经皮组VAS、NRS评分均低于开放组,差异有统计学意义(P < 0.05);2组术前、术后7 d、术后3个月椎体前缘高度比、椎体后凸角差异无统计学意义(P>0.05);经皮组并发症发生率为6.67%,低于开放组的23.33%,差异有统计学意义(P < 0.05)。
      结论  经皮与开放椎弓根螺钉内固定的疗效相近,但经皮椎弓根螺钉内固定能够缩短患者住院时间,减少术中出血量,减轻术后疼痛,降低并发症发生率。

     

    Abstract:
      Objective  To compare the efficacy of percutaneous and open internal fixation with pedicle screw in treatment of patients with spinal fractures.
      Methods  A total of 60 patients with spinal fractures were divided into percutaneous group and open group, with 30 cases in each group. The perioperative indicators, score of Visual Analogue Scale (VAS), score of Numeric Rating Scale (NRS), indicators of spine vertebral body, and postoperative complications were compared between the two groups.
      Results  The intraoperative blood loss was less, postoperative bedridden time and hospital stay of the percutaneous group were significantly shorter than those of the open group (P < 0.05). The VAS and NRS scores of the percutaneous group were significantly lower than those of the open group at two weeks after operation (P < 0.05). There were no significant differences in anterior vertebral height ratio and kyphosis angle of vertebral body between the two groups at the time points of before operation, 7 days after operation and 3 months after operation (P>0.05). The incidence of complications in the percutaneous group was 6.67%, which was significantly lower than 23.33% in the open group (P < 0.05).
      Conclusion  Curative effect is similar between percutaneous and open internal fixation with pedicle screw, but percutaneous internal fixation with pedicle screw can shorten the hospital stay, reduce intraoperative blood loss, alleviate postoperative pain and reduce the incidence of complications.

     

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